Non-FOOSH Scaphoid Fractures in Young Athletes

CONTEXT The scaphoid is the most commonly fractured bone in the wrist and can often be difficult to treat and manage, making healing of this fracture problematic. EVIDENCE ACQUISITION A search of the entire PubMed (MEDLINE) database using the terms scaphoid fracture management and scaphoid fracture evaluation returned several relevant anatomic and imaging references. RESULTS Wrist fractures most commonly occur in the scaphoid, which is implicated approximately 60% of the time. The most common mechanism of injury leading to a scaphoid fracture is a fall on an outstretched hand (FOOSH), causing a hyperextension force on the wrist. The following 2 cases, which occurred within 3 months of each other, highlight the difficulty of managing patients with possible scaphoid fractures. Neither patient had a typical FOOSH-related mechanism of injury, and neither was initially tender over the scaphoid. CONCLUSION Differential diagnoses should include a scaphoid fracture with any hyperextension traumatic injury (FOOSH or non-FOOSH), even in the absence of scaphoid tenderness and when initial radiographic findings are normal.